PowerPoint Presentation€¦ · 18-Jan-17 2 Objectives o Learn about the MEISR o Why - Foundational...
Transcript of PowerPoint Presentation€¦ · 18-Jan-17 2 Objectives o Learn about the MEISR o Why - Foundational...
18-Jan-17
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Virginia Early Intervention
10 February
Naomi Younggren, PhD2
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Rate your understanding about the MEISR.
Rate your confidence with using the MEISR.
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Ogle, D.M. 1986. K-W-L: A teaching model that develops active reading of expository text. Reading Teacher 39: 564-570.
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#2
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Objectives
o Learn about the MEISR
o Why - Foundational Framework
o What - Purpose, Uses, Development, & Organization
o How - Scoring
o Who, When, Where, & How - Implementation
o Explore how the MEISR can assist with the COS process
o Discover how it can help in the IFSP process
o Practice using the MEISR
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Materials you should have for today
VA MEISR For Pilot
Copy of today’s slides (PPT)
Activity sheet to accompany slides
VA Decision Tree
MEISR excel
William MEISR Exercise Bundle
Privy Information about William
William’s MEISR
William’s MEISR by Outcome Area
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Picture Credit & Useful Resource
http://www.cdc.gov/ncbddd/watchmetraining/index.html
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Note
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Foun
datio
nal F
rame
work
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Engagement
“The amount of time children spend
interacting with their environment
in a developmentally and contextually
appropriate manner.”
(McWilliam & Bailey, 1992, 1995)
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How does the foundational framework of the
MEISR align with your thinking about
early intervention?
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Purp
ose
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Purpose
Designed to help Families assess their young children’s
functioning in different routines.
Birth - three years of age.
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Uses
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Uses• Clarify goodness of fit between family routines and the child’s
abilities
• Guide family daily activities & routines discussions
• Help identify functional IFSP outcomes
• Assist teams with determining COS ratings
• Facilitate routines-based intervention
• Monitor child progress
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MisUses
• Exclusively used for eligibility determination
• Mechanically used to identify IFSP outcomes
based only on missed or next items
• Solely used to determine COS ratings
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The MEISR…
1. Is a standardized instrument.
2. Provides a profile of children’s functioning.
3. Can be completed by parents.
4. Is a curriculum for early intervention.
5. Generates COS ratings.
6. Can help parents define IFSP outcomes.
True or False
#4
Deve
lopme
nt
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Development
• 2007, 2010, 2012, and expected publication 2018
• Field tested with providers and families
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Age Guidelines
• Starting ages extrapolated from existing tests
and curricula
• Children vary considerably in their starting
ages for different skills
• Starting ages are considered good estimates
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Item Density by Age GroupItem Density by Age Group
zero - 5.9 6 -11.9 12 - 17.9 18 - 23.9 24 - 29.9 30 - 35.9 36
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Orga
nizat
ion
http://www.cdc.gov/ncbddd/watchmetraining/module4.html
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Organization
• 13 common family routines
• Intentional mix of Engagement, Independence,
and Social Relationships (EISR)
• Cross referenced
• EISR
• 5 Developmental Domains
• 3 National Child Outcomes
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Functional Skills In Day to Day Routines
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3. Getting
Dressed
4. Toilet/Diapering
2. Meal Times
5. Going Out6. Play with Others
7. Play By Self
1. Wake Up
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8. Napping
9. Bath Time
10. Hanging Out, Books/TV
11. Grocery
Shopping 12. Outside13. Bedtime
What Functional Abilities do you see?
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Number of Items for Each Routine
25
48
29
21
35
40
36
16
31
39
19
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0 10 20 30 40 50 60
1. WAKING UP
2. MEAL TIMES
3. GETTING DRESSED
4. TOILETING/DIAPER
5. GOING OUT
6. PLAY TIME WITH OTHERS
7. PLAY TIME BY HIM- OR HERSELF
8. NAPPING
9. BATHING
10. HANGING OUT/WATCHING TV/BOOKS
11. GROCERY SHOPPING
12. OUTDOORS
13. BEDTIME
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Item Density by theThree National Child Outcomes
Item Density by O's
O1 O2 O3
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Item Density by theDevelopmental Domains
18%
18%
23%
19%
22%
Items by Developmental Domains
Adptive Cognitive Communication Motor Social
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Item Density by theDevelopmental Domains
0 10 20 30 40 50 60 70 80 90 100
Adptive
Cognitive
Communication
Motor
Social
Item Density by Developmental Domains
and Domain Clusters
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Scor
ing
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Scoring• Scale
• 1 not yet
• 2 sometimes
• 3 often
• 3 beyond this
• Percentage of mastered functional skills for age• By routine
• By 3 National outcomes
• By domain
• By E-I-SR• Overall
• Percentage of mastered functional skills for total skills• By routine
• By 3 National outcomes
• By domain• By E-I-SR
• Overall
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3 is considered mastered
MEISR Summary Scoring SheetBy Routine for Age & By Routine for Total Items
Scoring Summary
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Emmitt - 13 months old
10/19 = 53% mastered of age for wake up
Emmitt - 13 months old
Scoring Mastery by Routine for Age (Lucas 24 months)
In the “Getting Dressed” routine Lucas has mastered 13
of the 21 (62%) functional skills for his age (24 mo.). 35
= 1321=
Scoring Mastery by Routine for Age (Lucas 24 months)
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Scoring Mastery by Routine for Total Items (Lucas 24 mo.)
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In the “Getting Dressed” routine Lucas mastered 13
of all 29 (45%) functional skills. 37
Scoring Mastery by Routine for Age & by Routine for Total Items(Lucas 24 months)
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(Luc
as 2
4 mo
nths
)
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10 4 17 6
40
= 37
10 (27%) 4 (11%) 23 (62%)
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Often & Beyond combined to ease profile viewing #7
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2 4 5 9 56%9 64%14 3
Imple
ment
ation
http://www.cdc.gov/ncbddd/watchmetraining/module2.html
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Implementation - Who
• Parent completed
• Team collaboration
• Family interview / The RBI
• Combination of above
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Implementation – When (Entry to Exit)
• Intake
• Assessment for Service Planning
• IFSP Development
• Service Delivery, including ongoing assessment
• IFSP Review
• Annual IFSP
• Exit
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Implementation - Wherever
https://www.pinterest.com/pin/164874036334811522/
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Implementation - How
• With Family Interview or The RBI
• As part of Functional Assessment
• Family Completed
• Combination
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Family Interview
How could the MEISR help me with interviewing
families about their “Daily Activities & Routines”?
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Family InterviewPrepare the MEISR for the child’s age &
what you already know, but only if you already know
With Family Interview (or RBI)Breakfast (Lucas 24 months)
Breakfast is in the kitchen. He eats with the rest of us . He and the girls usually have cereal. If it’s on the run the girls will give him a pop tart. He can’t get the wrapper off. If he needs help he doesn’t ask, he’ll just tries to bite through the wrapper. He doesn’t have much patience to wait, even for 5 minutes if he wants something. Rather he fusses ti l l someone helps.
Fortunately, most breakfasts that are not on the run and Lucas follows directions to sit at the table initially. But he does not stay at the table.
He sits in a regular chair at first, but squirms, up on knees and down on bum and up again. He comes and goes from the table, we often have to chase him back to the table
When eating he eats by himself and no longer needs to be fed. He chews his food well – no stuffing or drooling. He uses a spoon well and by himself, he spills some. He can take little bites. He’ll pick up (pinch) small bits and
eat them one at a time. At meals he can be picky. A favorite is chicken nuggets. He says “No” when I give him something he doesn’t l ike.
Veggies always get a No. He drinks from a sippy cup. But not a regular cup, he dumps that. When he’s done eating he pushes the bowl away or just leaves the table without returning. If he wants more he’ll reach or point for things, even climb on the table, I don’t l ike that He can say eat and drink, but doesn’t always say that but goes to get what he wants. More and finished are no
t yet part of his vocabulary. After breakfast if he played more than ate and the things are put away he sometimes asks for drink by saying
juice. He’ll say waf for waffles – he loves waffles. He knows cookie too and where they are kept on top of the fridge. He’ll point and ask for cookie. He knows wh
en I point to cookie that means it’s cookie time. If I ask him a couple of things l ike to go get something he doesn’t seem to understand, l ike bring me the milk
and your cup. But he does follow simple directions to throw things in the trash. He is very tuned into the girls , he even imitates what they do. They play a face game it’s funny. 51
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Functional Assessment
How could I use the MEISR when observing children?
#10
Lucas (24 months)
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Observing Lucas (24 mo.)#11
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With Functional Assessment
Observations (Outdoors)
• Climbs up slide using feet and hands, gets almost to the top • Goes down slide backwards on feet holding on, then turns around and
goes down on bum• Does again on the parallel slide, getting closer, but not to the top• Slides down backwards on belly, turns around stands on end of slide• Jumps off slide from standing position with both feet• Walks up slide steps one foot on a step and using hand rail. On hands and
knees at first landing then walks up remaining steps. • Sits down at top of slide and slides down• Runs across playground across grass and sidewalk• Follows after ball, picks it up, tosses it up and forward with both hands• Throws ball upward underhanded at small basket hoop• Runs after ball when it rolls away, goes toward road
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Some items were not observed
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Parent Completed
How might I invite/encourage families to complete the MEISR.
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Parent Completed
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Family Interview, Functional Assessment, Parent Completed
How could weuse the MEISR in a combination
of different ways?
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Using
the
exce
l spr
eads
heet
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MEISR - Excel spreadsheet
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Summary Score Sheet in Excel
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COS
Proc
ess
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https://www.cdc.gov/ncbddd/watchmetraining/module4.html#objective-3
Enter “custom sort” to organize by outcome and age
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Enter sort by 2 levels: Outcome and Starting Age
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Open the excel spreadsheet & practice
1. Sort items by outcome2. Then sort by age
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MEISR sorted by outcome & age
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Functional Skills
AE
IF
Missing AE and IF functioning
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Considering all the information gathered…
• Are the skills and behaviors demonstrated what one would expect for a child this age? AE
• Are they like those of a younger child? Are they the skills and behaviors that come just before
the age-expected skills and behaviors? IF
• Are they like those of a MUCH younger child? Are they farther away from age expected skills
and behaviors? (much earlier or atypical skills and behaviors) F
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Using the Decision Tree is Key!
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Use theMEISRto assist with Decision Tree discussions
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Sophie (9 month) COS mini exerciseFrom the information below what do you know about Sophie’s skills in Outcome 2?
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IFSP
Dev
elopm
ent
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IFSP Outcome Identification
• What would you like Teddy to be
able to do?
• What are activities would you like
Teddy and your family to be able
to do?
• In 6 months to a year what would
you like your child to do?
• What do you want to work on?
• Based on our assessment the
next important steps for Teddy
would be…
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MEISR can help teamsidentify functional and specific
IFSP outcomes
IFSP Outcome Identification
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Earlier, you identified _____ and
_____ as your priorities. As we
have talked through your
routines and discussed the
assessment, we noted that ____,
_____ and _____ also seem to be
challenging. In light of that,
what is most important to
you to work on first?
• Alex will participate in toileting by
lowering his pants before sitting
on the potty +measurement criteria
• Baldwin will play appropriately
(not throw) with toys in the sandbo
x outside in the backyard +
+ measurement criteria
• Carmen will eat a variety of foods (beyond chicken nuggets and pasta)
at lunch and dinner + measurement
criteria
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• Alex will increase
independence with
toileting.
• Baldwin will stop
throwing toys in the
sandbox.
• Carmen will tolerate
eating different foods.
Functional, Contextual,
Positive, Active, and
Discipline and Jargon Free
Vague, Negative, Passive,
Discipline Particular
Reminder! IFSP Outcomes must include 1) functional skill, 2) the routine/activity, and 3) measurement of achievement
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Sophie (9 month) mini IFSP exercise
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Serv
ice D
elive
ry
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Welcoming early interventionists to work on the functional priorities
I set for my child and family
Remembering the names and faces of different providers and trying to decipher what they are doing and sharing
Prac
tice
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https://www.cdc.gov/ncbddd/watchmetraining/module4.html#objective-3
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Materials• Video clip “Meeting William” – we’ll watch this together (video)
William MEISR Exercise Bundle (paper)
VA Decision Tree (paper)
Actions (Small Groups Assigned 1 of the 3 Outcomes to Focus On)
1. Conduct functional assessment – get to know William.
2. Use all information (including excel sort) to DRAFT what you know about
William’s functioning for your assigned outcome. Use IFSP Section II: Team Assessment to write your draft.
3. Use information including the MEISR to work through the COS process
with the Decision Tree for your assigned outcome (Child’s Development in
Relation to Other Children the Same Age).
4. Use the MEISR and other information available to help identify two
possible IFSP outcomes.
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Observing William (30 mo.)#17
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In your groups for the outcome you are assigned…
1. Conduct functional assessment – get to know William.
2. Use all information (including excel sort) to DRAFT what you know
about William’s functioning for your assigned outcome. Use IFSP
Section II: Team Assessment to write your draft.
3. Use information including the MEISR to work through the COS process
with the Decision Tree for your assigned outcome (Child’s Development in
Relation to Other Children the Same Age).
4. Use the MEISR and other information available to help identify two
possible IFSP outcomes
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#17
Tell us how it went. What did you learn?
What do you wonder about?
Using
the
MEI
SR
in yo
ur P
roce
ss
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https://www.cdc.gov/ncbddd/watchmetraining/module2.html#objective-1
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ExitAnnual6 mo.
ReviewIFSP
(COS)Assessment
Intake
How might it be used in your process?
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FAQ
Jot down the questions that come to mind.
We’ll review these in our follow up webinars too.
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For the MEISR Pilot… My next
step is to………
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• Monthly March - July
#1 on
# 2-6 - To be Scheduled
• Please send in questions and the things you wonder about ahead of time
• Topics will evolve as we proceed
Follow UpWebinars